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HomeMy WebLinkAboutReceipt FormP:escnbed by Staie Board 01 A~count. BOY~Fo;msSystem.. MunCIe. In .' ." O. . RECEIPT \\0 ., DEPARTMENT OF COMMUNITY SER\iICES ".NERAL""PORM'HO. 3t1Z (RE.V. 1987) ../\. (L"J . A '.l ;~ I " (it llY\J/ \.;L. If \J N2 2188 CARMEL IN.. l t' ,. RECEIVED FROM [/ THE SUM OF ON ACCOUNT OF : , i! ),..-,'1 f l,1 .<,t U7 if !J ( ,'...A' i -....1.1 "t./f' \./ ~""",?,""'~ . ..........T1\h......!.I'.J,........ l, : J 'i' ,l..~ l .".f {rD . -.. _" ""(""1,/" '..C ..., t -t j/ . ;"" vt I i ,\ 1 C\ ....~l j'o 1''\ I .c::, IV! i I ! () I"~ I ,,::l,. r\ .~)6'-""')'iI1.i {' f1(i . . , 1J" 1 "....f 1 .",., .I") .'"' ! J..." :...t!''''lV f\, '7 20 l>.,,,,\ i . ;'''''f' .1 " J- i"ll '\ ,': .,J ~ ,.., ~:;'\ ,'. ,. ,. "..", \..J . PAYMENT TYPE a AMOUNT I"J /.( i CASH CHECK \ " E.F.T c.c.fa.c j(i~'f\ t.A.... \~, +1.., ,"t , 1/.':" ,,'" . t..~ ~ I' I" ~- '. ,'.'../ \0 f. jJ . 1 t ~~.. . -':..," ;..~..,~' r'. I .< ....-';<, )<(~ ~..... :' {VVt'~lvl,.;' AUTHORIZED SIGNAT\iREii' M.O. { '~ {~. ,h~/i h'\ ;' ,_..'" 1;.,__ ~.-~,# J OTHER